Role of Colour Doppler Ultrasonography in Diagnosing Acute Scrotum: A Retrospective Study

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Abstract (English)

Abstract
Aim: To determine the use of colour Doppler ultrasonography in diagnosing acute scrotum.
Material and Methods: This study was conducted in the department Radiology, Katihar Medical college and
Hospital, Katihar, Bihar, India for one year. All patients of age group of ≤25 yearswith acute scrotum were
admitted and subjected to detailed history and physical examination with emphasis on pulse, temperature, general
and local examination findings. Baseline investigations involving hemogram, urine routine examination, urine
culture with sensitivity and KFT were carried out in all patients. All patients were subjected to immediate Doppler
ultrasonography scrotum. Scrotal Doppler ultrasonography was performed with the patient lying in a supine
position and the scrotum supported by a towel placed between the thighs. (Optimalresults were obtained with 7
to 14 MHz high-frequency linear-array transducers).
Results: 50 patients of acute scrotum presented to surgical department who were ≤25 years, over a period of two
years comprising 0.11% among 45260 total patients attended the surgery department. Patients presented with
clinical features of pain in scrotum, swelling of hemiscrotum, nausea vomiting, fever, urinary symptoms,
abdominal pain and tender scrotum with erythema. Most common presentation was scrotal pain and scrotal
swelling. True positive-20, False positive-2, True negative-25, False negative-3. True positive-20, False positive0, True negative-29, False negative-1. True positive-2, False positive-0, True negative-47, False negative-1. Three
patients with equivocal Doppler findings, but strong clinical suspicion of testicular torsion was explored, and testis
was found to be torsed in all the three patients.
Conclusion: Acute scrotum in children and young adults is a surgical emergency. Proper diagnosis and timely
intervention can save testis and avoid unnecessary scrotal exploration. Color Doppler is an excellent modality of
investigations which helps in correct diagnosis and timely intervention.